应用系统提示法干预孤独症谱系障碍幼儿自发性共同注意的效果

Effect study of applying systematic prompting intervention on initiating joint attention for children with autism spectrum disorders

目的:探究应用系统提示法干预孤独症谱系障碍(ASD)幼儿自发性共同注意的效果。方法:选取27名ASD幼儿的主要看护者应用系统提示法对其实施自发性共同注意干预。以自发性共同注意观测量表中视线转换、指示与展示3项自发性共同注意行为为观测指标,通过对比被试3项观测指标在基线期(A1)与维持期(A2)及追踪期(A3)中得分的变化,检验干预方案的效果及其维持性与泛化性。结果:经非结构化观测,共有23名被试接受了视线转换行为的干预、全体27名被试接受了指示与展示行为的干预。被试3项自发性共同注意行为在A1的观测轮次分别为4.48±0.99、4.37±1.08、3.78±0.70,在A2、A3的观测轮次均为3。经统计,被试视线转换行为在A1、A2、A3的得分分别为4.54±0.76、9.01±0.72、8.86±0.82,其中,A1与A2、A3得分的重叠率均为0%,比较差异均有统计学意义(t=-96.949,-65.937;P<0.05);被试指示行为在A1、A2、A3的得分分别为2.71±0.58、8.48±0.87、8.09±0.58,其中,A1与A2、A3得分的重叠率均为0%,比较差异均有统计学意义(t=-71.912,-69.527;P<0.05);被试展示行为在A1、A2、A3的得分分别为1.27±0.75、5.77±1.47、1.33±0.75,其中,A1与A2得分的重叠率为0%,比较差异有统计学意义(t=-28.415,P<0.05),A1与A3得分的重叠率为85.19%,比较差异无统计学意义(P>0.05)。结论:基于系统提示法的自发性共同注意干预方案能够有效提升ASD幼儿视线转换、指示与展示3项自发性共同注意行为并具备良好的维持性,但展示行为干预效果的泛化性不及视线转换与指示行为。

Objective:To explore the effect of Systematic Prompting intervention on initiating joint attention for children with autism spectrum disorders(ASD).Methods:A total of 27 primary caregivers of ASD children were selected to perform initiating joint attention intervention with Systematic Prompting.Behaviors of alternate,point and show from initiating joint attention observation scale were taken as observation indexes,by comparing the three subjects'three observation indexes changes among the baseline period(A1),maintenance period(A2)and follow-up period(A3),We verified the effectiveness of the intervention program and its maintainability and generalization.Results:Through the unstructured observation,23 subjects received alternate intervention,all 27 subjects received point and show intervention.Three initiating joint attention behaviors'observation rounds of A1 were 4.48±0.99,4.37±1.08,and 3.78±0.70,the observation rounds of A2 and A3 were both 3.By the statistics,the scores of subjects'alternate behavior in A1,A2 and A3 were 4.54±0.76,9.01±0.72,and 8.86±0.82,among them,the scoresoverlap rate of A1 and A2,A3 were both 0%,which showed statistically significant difference(t=-96.949,-65.937;P<0.05);The scores of subjects'point behavior in A1,A2 and A3 were2.71±0.58,8.48±0.87,and 8.09±0.58,among them,the scores overlap rate of A1 and A2,A3 were both 0%,which showed statistically significantdifference(t=-71.912,-69.527;P<0.05);The scores of subjects'show behavior in A1,A2 and A3 were1.27±0.75,5.77±1.47,and 1.33±0.75,respectively,the scores overlap rate of A1 and A2 scores was 0%,which showed statistically significant difference(t=28.415,P<0.05).The scores overlap rate of A1 and A3 scores was 85.19%,which showed no significant difference.Conclusion:The initiating joint attention intervention programs based on systematic prompting can effectively improve the initiating joint attention behaviors of ASD children and has good maintenance,but the generalization of show is not as good as alternate and point.